EP2470187B1 - Emergency interventions of active charcoal with dabigatran etexilate overdosing - Google Patents

Emergency interventions of active charcoal with dabigatran etexilate overdosing Download PDF

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Publication number
EP2470187B1
EP2470187B1 EP10747022.1A EP10747022A EP2470187B1 EP 2470187 B1 EP2470187 B1 EP 2470187B1 EP 10747022 A EP10747022 A EP 10747022A EP 2470187 B1 EP2470187 B1 EP 2470187B1
Authority
EP
European Patent Office
Prior art keywords
charcoal
dabigatran
dabigatran etexilate
pellets
overdosing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP10747022.1A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP2470187A1 (en
Inventor
Joanne Van Ryn
Andreas Clemens
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Boehringer Ingelheim International GmbH
Original Assignee
Boehringer Ingelheim International GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Boehringer Ingelheim International GmbH filed Critical Boehringer Ingelheim International GmbH
Priority to PL10747022T priority Critical patent/PL2470187T3/pl
Publication of EP2470187A1 publication Critical patent/EP2470187A1/en
Application granted granted Critical
Publication of EP2470187B1 publication Critical patent/EP2470187B1/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00Medicinal preparations containing inorganic active ingredients
    • A61K33/44Elemental carbon, e.g. charcoal, carbon black
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41641,3-Diazoles
    • A61K31/41841,3-Diazoles condensed with carbocyclic rings, e.g. benzimidazoles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/4427Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
    • A61K31/4439Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. omeprazole
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0053Mouth and digestive tract, i.e. intraoral and peroral administration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/14Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/16Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
    • A61K9/167Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction with an outer layer or coating comprising drug; with chemically bound drugs or non-active substances on their surface
    • A61K9/1676Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction with an outer layer or coating comprising drug; with chemically bound drugs or non-active substances on their surface having a drug-free core with discrete complete coating layer containing drug
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P39/00General protective or antinoxious agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2121/00Preparations for use in therapy

Definitions

  • the invention relates to charcoal for use in the treat an overdosing with active substance dabigatran etexilate of formula I optionally in the form of the pharmaceutically acceptable salts thereof.
  • the compound of formula 1 is known from the prior art and was first disclosed in WO98/37075 . It is a potent thrombin inhibitor which can be used for example for the post-operative prevention of deep vein thromboses and in stroke prevention, particularly for preventing strokes in patients with atrial fibrillation.
  • WO 03/074056 discloses the methanesulphonic acid addition salt of dabiagtran-etexilate (ie: dabigatran etexilate methansulphonate) to be particularly useful.
  • pellet formulations may be used, as disclosed for example in WO 03/074056 .
  • These formulations are compositions in which an active substance layer containing binder and optionally separating agent is applied to a substantially spherical core material that consists of or contains a pharmaceutically acceptable organic acid.
  • the core layer and the active substance layer are separated from one another by a so-called isolating layer.
  • the schematic structure of an active substance formulation of this kind is shown in Figure 1 of WO 03/074056 .
  • Dabigatran etexilate (I) is a prodrug, which is rapidly converted in vivo to the active moiety dabigatran (compound of formula II), a potent, direct thrombin inhibitor. i.e., dabigatran etexilate is only converted into the compound which is actually effective, namely dabigatran, in the body.
  • This drug is currently being tested for stroke prevention in patients with atrial fibrillation (SPAF) and is administered over longer time periods in these patients as warfarin replacement. Due to risks for bleeding complications under chronic anticoagulant treatment, there may be a need for emergency neutralization of the drug.
  • SPF atrial fibrillation
  • the instant invention is directed to a possible solution of the aforementioned problem.
  • the invention relates to charcoal for use in the treatment of an overdosing with active substance dabigatran etexilate of formula I optionally in the form of the pharmaceutically acceptable salts thereof.
  • the invention relates to the neutralzation of dabigatran etexilate in the stomach of a patient wherein an effective amount of active charcoal is administered orally to a patient in need thereof.
  • the effective amount of active charcoal is usually in a range of 20 - 130 g, preferably in the range of 50 - 100g.
  • the amount of charcoal used depends on the degree of overdosing.
  • Dabigatran etexilate I is a double prodrug of dabigatran, the compound of Formula ( II ) i.e., dabigatran etexilate I is only converted into the compound which is actually effective, namely dabigatran II , in the body.
  • the invention relates to the neutralization of dabigatran II in the the blood plasma, the method comprising purification of the blood plasma of the patient over active charcoal.
  • the absorption of overdosed dabigatran II from the blood plasma could be performed via hemoperfusion over a charcoal filter.
  • the core 1 is produced from pharmaceutically acceptable organic acid.
  • tartaric acid is used to prepare the core 1 .
  • the core material 1 thus obtained is then converted into so-called isolated tartaric acid cores 3 by spraying on an isolating suspension 2 .
  • a dabigatran suspension 4 prepared subsequently is sprayed onto these coated cores 3 in one or more process steps by means of a coating process.
  • the active substance pellets 5 thus obtained are then packed into suitable capsules.
  • Measuring device Air jet screen, e.g. Alpine A 200 LS Screens: As required Weight put in: 10g/screen Duration: 1 min/screen, then 1 min each up to the maximum weight loss of 0.1g
  • the substance is transferred into a mortar and any lumps present are destroyed by intensive pounding.
  • the screen with rubber seal and cover is placed on a balance, set to zero and 10.0 g of the pounded substance are weighed onto the screen.
  • the screen together with its contents, rubber seal and cover are placed on the device.
  • the timer is set to 1 minute and the material is treated by air jet screening for this time.
  • the residue is weighed out and documented. This process is repeated until the decrease in the weight of the residue after air jet screening is ⁇ 0.1 g.
  • 1000 kg tartaric acid are added to a slowly rotating (3 revolutions per minute) unperforated horizontal pan with a spraying and powder applying unit (e.g. Driamat 2000/2.5).
  • a sample of the acid is taken for screening analysis.
  • the acid in question is tartaric acid particles with a particle size in the range from 0.4-0.6 mm.
  • the acid rubber solution obtained by the above method is sprayed onto the tartaric acid particles thus provided.
  • the quantity of air supplied is adjusted to 1000m 3 /h and 35°-75°C.
  • the differential pressure is 2 mbar and the speed of rotation of the pan is 9 revolutions per minute.
  • the nozzles should be arranged at a distance of 350 - 450 mm from the filling.
  • the acid rubber solution is sprayed on by alternating with the following steps. After about 4.8 kg of the acid rubber solution has been sprayed onto the tartaric acid particles of particle size 0.4-0.6 mm and the solution has been distributed, about 3.2 kg tartaric acid powder are sprinkled onto the damp tartaric acid particles.
  • the tartaric acid powder in question consists of fine tartaric acid particles with a particle size of ⁇ 50 microns. In all, 800 kg tartaric acid powder are required. After the said tartaric acid powder has been sprinkled on and distributed the spray material is dried until a product temperature of about 40°C is reached. This is in turn followed by the spraying on of the acid rubber solution.
  • the acid pellets are dried in the pan at 3 rpm for 240 minutes.
  • an intermittent program is run at 3 rpm for 3 minutes every hour. In the present instance this means that the pan is rotated at 3 rpm for 3 minutes at intervals of one hour and then left to stand.
  • the acid pellets are then transferred into a dryer. They are then dried at 60°C over a period of 48 hours.
  • the particle size distribution is determined by screen analysis. The particle size with a diameter of 0.6 - 0.8 mm corresponds to the product. This fraction should make up >85%.
  • the acid pellets 1200 (600) kg are poured into the coating apparatus (e.g. GS-Coater Mod. 600/Mod. 1200) and sprayed therein in the rotating pan with the isolating suspension described above in a continuous spraying process lasting several hours at a spraying rate of 32 kg/h for the 1200 kg mixture or 21 kg/h for the 600 kg mixture.
  • the pellets are also dried continuously with an air supply at up to 70°C.
  • the isolated starter pellets are fractionated by screening.
  • the product fraction with a diameter ⁇ 1.0 mm is stored and used further.
  • Any clumps formed are broken up by homogenising using an UltraTurrax stirrer (about 60-200 minutes).
  • the suspension temperature should not exceed 30°C throughout the entire manufacturing process.
  • the suspension is stirred until ready for further processing to ensure that no sedimentation occurs (at roughly 400 rpm).
  • the suspension is stored at below 30°C, it should be further processed within at most 48 h. If for example the suspension is manufactured and stored at 22°C, it may be further processed within 60 hours. If the suspension is stored for example at 35°C it should be further processed within at most 24 h.
  • a horizontal pan with an unperforated container is used (GS Coater Mod. 600).
  • the suspension is sprayed onto the fluidised bed of pellets in the rotating pan by the "top spray” method. It is sprayed on through nozzles 1.4 mm in diameter.
  • the dry air is passed into the bed of pellets through so-called immersion blades and transported away through an opening in the back wall of the coater.
  • the horizontal pan is charged with 320 kg of the tartaric acid pellets obtained according to Example 2 and the bed of pellets is heated up. Once a product temperature of 43 °C has been reached, spraying begins. 900 kg of the suspension prepared previously according to Example 3 are sprayed on, first of all for 2 h at a spraying rate of 20 kg/h, then 24 kg/h and a spray pressure of 0.8 bar. The suspension is stirred constantly. The temperature of the air supplied is at most 75°C. The amount of air supplied is about 1900 m 3 /h.
  • pellets are dried in the horizontal pan (5 revolutions per minute) at an air inflow temperature of at least 30°C, at most 50°C and an air inflow amount of 500 m 3 /h over a period of about 1-2 hours.
  • 325 kg of the pellets thus obtained are then loaded once more into a horizontal pan and heated to 43°C.
  • 900 kg of the suspension prepared previously according to Example 3 are sprayed on, first of all for 2 h at a spraying rate of 20 kg/h, then 24 kg/h and a spray pressure of 0.8 bar.
  • the suspension is stirred constantly.
  • the temperature of the air supplied is at most 75°C.
  • the amount of air supplied is about 1900 m 3 /h.
  • pellets are dried in the horizontal pan (5 revolutions per minute) at an air inflow temperature of at least 30°C, at most 50°C and an air inflow amount of 500 m 3 /h over a period of about 1-2 hours.
  • the dried pellets are then passed through a vibrating screen with a mesh size of 1.6 mm and stored in containers with desiccants until needed for further processing.
  • dabigatran was added to a plasma pool at supra-therapeutic concentrations of 470 and 940 ng/ml. The sample was then split, and active charcoal was added to half at the manufacturer's specified concentration (125 mg/ml), or 1:11 dilution of this. Dabigatran plasma levels were measured by a validated LC-MS/MS method.

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  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Epidemiology (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Inorganic Chemistry (AREA)
  • General Chemical & Material Sciences (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Toxicology (AREA)
  • Nutrition Science (AREA)
  • Physiology (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicinal Preparation (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Organic Low-Molecular-Weight Compounds And Preparation Thereof (AREA)
  • Nitrogen Condensed Heterocyclic Rings (AREA)
  • Information Retrieval, Db Structures And Fs Structures Therefor (AREA)
EP10747022.1A 2009-08-24 2010-08-23 Emergency interventions of active charcoal with dabigatran etexilate overdosing Active EP2470187B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PL10747022T PL2470187T3 (pl) 2009-08-24 2010-08-23 Interwencje przy użyciu węgla aktywnego w nagłych przypadkach przedawkowania eteksylanu dabigatranu

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US23632109P 2009-08-24 2009-08-24
PCT/EP2010/062229 WO2011023653A1 (en) 2009-08-24 2010-08-23 Emergency interventions of active charcoal with dabigatran etexilate overdosing

Publications (2)

Publication Number Publication Date
EP2470187A1 EP2470187A1 (en) 2012-07-04
EP2470187B1 true EP2470187B1 (en) 2013-08-21

Family

ID=42740360

Family Applications (1)

Application Number Title Priority Date Filing Date
EP10747022.1A Active EP2470187B1 (en) 2009-08-24 2010-08-23 Emergency interventions of active charcoal with dabigatran etexilate overdosing

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US (2) US20110206656A1 (zh)
EP (1) EP2470187B1 (zh)
JP (1) JP2013502449A (zh)
KR (1) KR20120050457A (zh)
CN (1) CN102481317B (zh)
AR (1) AR077909A1 (zh)
AU (1) AU2010288601A1 (zh)
BR (1) BR112012004169A2 (zh)
CA (1) CA2767966A1 (zh)
CL (1) CL2012000488A1 (zh)
DK (1) DK2470187T3 (zh)
EA (1) EA201200319A1 (zh)
ES (1) ES2436076T3 (zh)
IL (1) IL216968A0 (zh)
MX (1) MX2012001767A (zh)
NZ (1) NZ597359A (zh)
PL (1) PL2470187T3 (zh)
TW (1) TW201124143A (zh)
WO (1) WO2011023653A1 (zh)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TWI513466B (zh) 2010-01-20 2015-12-21 Boehringer Ingelheim Int 抗凝血劑解毒劑
AP2013007046A0 (en) * 2011-03-30 2013-08-31 Boehringer Ingelheim Int Anticoagulant antidotes
GB201120693D0 (en) * 2011-12-01 2012-01-11 Convatec Technologies Inc Wound dressing for use in vacuum therapy
CN114452839B (zh) * 2022-02-10 2023-04-21 中南大学湘雅医院 一种抗凝抗栓血液净化膜及其制备方法

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5277820A (en) * 1992-02-06 1994-01-11 Hemocleanse, Inc. Device and method for extracorporeal blood treatment
PE121699A1 (es) 1997-02-18 1999-12-08 Boehringer Ingelheim Pharma Heterociclos biciclicos disustituidos como inhibidores de la trombina
MXPA04008542A (es) 2002-03-07 2004-12-06 Boehringer Ingelheim Pharma Forma de administracion para aplicacion oral, de ester etilico de acido 3-[(2- {[4 -(hexiloxicarbonilamino -imino-metil) -finilamino] -metil}-1 -metil- 1h-bencimidazol -5-carbonil) -piridin-2 -il-amino]- propionico y sales de la misma.

Also Published As

Publication number Publication date
CN102481317B (zh) 2014-09-03
ES2436076T3 (es) 2013-12-26
KR20120050457A (ko) 2012-05-18
WO2011023653A1 (en) 2011-03-03
US20130302311A1 (en) 2013-11-14
NZ597359A (en) 2014-01-31
IL216968A0 (en) 2012-02-29
EA201200319A1 (ru) 2012-09-28
CL2012000488A1 (es) 2012-08-31
DK2470187T3 (da) 2013-10-28
BR112012004169A2 (pt) 2016-03-29
CN102481317A (zh) 2012-05-30
MX2012001767A (es) 2012-02-29
US20110206656A1 (en) 2011-08-25
AU2010288601A1 (en) 2012-02-02
TW201124143A (en) 2011-07-16
JP2013502449A (ja) 2013-01-24
PL2470187T3 (pl) 2014-01-31
AR077909A1 (es) 2011-09-28
CA2767966A1 (en) 2011-03-03
EP2470187A1 (en) 2012-07-04

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